My 13 year old cousin has diabetes and has had it since she was five or six. My mother informed me today that she may also be suffering from kidney and thyroid disease. HELP! On December 26, my boyfriend’s best friend died of kidney cancer at the age of 27. Our friends and his family are devastated. He also had diabetes. I am concerned because my little cousin doesn’t want to take the prescribed medication to help with these diseases. What can I do? What should I do? Will she die? What other avenues are there for her mother and our family to take?

You ask some complicated questions about your cousin. Here is what we know, in brief: type 1 diabetes, the kind that most kids get, is an autoimmune disease. This means that the body “attacks” itself. We really don’t know why. Research suggests that genetics is important in setting up a predisposition to such diseases, probably something in the environment, foods (cows’ milk proteins, wheat, for example) or viruses may be triggers, rather common things most of us get exposed to.

Other disorders, such as thyroid problems, often are also autoimmune disorders and, so, the same genetic predisposition overlaps. Thyroid disease is commonly seen in type 1 diabetes, about 20 to 40% of the time. The good news is that thyroid disease is usually easy to diagnose and easy to treat compared to diabetes. But, if one is hypothyroid from any reason, one has to take a pill once a day. If your cousin has hypothyroidism and does not take the pill or her family does not supervise this correctly, then the hypothyroidism is not treated. This can be associated with poor growth, menstrual problems, bone problems, heart problems, skin and hair problems, brain problems, etc. None of this has to happen with proper diagnosis and medication.

The kidney problems associated with diabetes reflect whether or not the blood glucose levels are being controlled. With proper treatment and control of the diabetes itself, we think that the kidney problems can likely be minimized greatly and, perhaps, even totally avoided. The same with eye problems and nerve problems associated with diabetes.

The bottom line is that there is not much you can do for your cousin except talk to her and talk to your other relatives to try to find out why they are not able to follow the advice of their diabetes team. Your support would be helpful. Maybe you can even go to one of the appointments with them and discuss this with the team yourself.

Your worries about cancer are not correct since there is no association with thyroid cancer and kidney cancer and diabetes at all.

SB